Provider Demographics
NPI:1437138567
Name:HALSTEAD, CLAUDIA J (PAC)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:J
Last Name:HALSTEAD
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:MS
Other - First Name:CLAUDIA
Other - Middle Name:JOY
Other - Last Name:HALSTEAD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PAC
Mailing Address - Street 1:PO BOX 3012
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19804-0012
Mailing Address - Country:US
Mailing Address - Phone:800-456-4629
Mailing Address - Fax:302-224-2848
Practice Address - Street 1:424 SAVANNAH RD
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958
Practice Address - Country:US
Practice Address - Phone:302-645-3296
Practice Address - Fax:302-645-3862
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC50000268363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE005144S72Medicare ID - Type Unspecified
P03740Medicare UPIN